The American Pain Society recommends that pain be made more visible and categorized as the fifth vital sign. Terminal illnesses are often accompanied by unbearable pain that is severe and difficult to treat.
Physicians are often reluctant to administer large doses of analgesic drugs for fear of respiratory depression or other complications. The same holds true for currently available opioid-based drug therapies which can produce undesirable side effects such as hallucinations, constipation, sedation, nausea and dysphoria.
Pain management is a great challenge for health care professionals as pain often can debilitate individuals in ways that affects their day-to-day functioning and productivity. Arthritis, for example, has been particularly problematic for women. Since 1999 there has been a 22 percent increase in the number of women who attribute their disability to arthritis.
Health economists writing in The Journal of Pain in September 2012, reported that the annual estimated national cost of pain management ranges from $560 billion to $635 billion.
The literature has reported the use of cannabis to treat pain and the use of methylcobalamin to treat peripheral neuropathy:                1. Stander, S., M., Schmelz, D. Metze, T. Luger, and R. Rukwied. “Distribution of cannabinoid receptor 1 (CB1) and 2 (CB2) on sensory nerve fibers and adnexal structures in human skin” Journal of Dermatological Science 38.3 (2005): 177-188        2. Manzanares, J., M. Julian and A. Carrascosa. “Role of the Cannabinoid System in Pain Control and Therapeutic Implications for the Management of Acute and Chronic Pain Episodes” Current Neuropharmocology. 4.3 (2006): 239-257        3. Jorge, L. L., C. C. Feres and V. E. Teles. “Topical preparations for pain relief: efficacy and patient adherence” Journal of Pain Research. 4 (2011): 11-24.        4. Wantanabe, T., R. Kaji, N. Oka, W. Bara and J. Kimura. “Ultra-high dose methylcobalamin promotes nerve regeneration in experimental acrylamide neuropathy” Journal of the neurological sciences 122.2 (1994): 140-143        5. Naik, S. U. and D. V. Sonawane. “Methylcobalamine is effective in peripheral neuropathies.” European journal of clinical nutrition (2015).        